Rapid vs Standard Induction to Injectable Extended-Release Buprenorphine

A multicenter, randomized clinical trial (729 participants; 28 outpatient treatment centers) compared two buprenorphine induction strategies for initiating extended-release buprenorphine: rapid induction (RI) and standard induction (SI). All participants received two injections of extended-release buprenorphine (one week apart) after induction. RI interventions consisted of a single 4 mg transmucosal buprenorphine-naloxone dose, while SI interventions involved at least 7 days of clinician-determined standard therapeutic dosing of transmucosal buprenorphine-naloxone (often 8-24 mg/day). RI onto extended-release buprenorphine was well tolerated and had higher retention for the second injection than SI (66.4% vs. 54.5%; difference, 11.8%). RI also had higher retention than SI in more difficult-to-treat fentanyl-positive participants. RI did not increase the frequency or severity of adverse events. These data add to the evolving published evidence supporting the effectiveness and safety of single-day buprenorphine initiation with or without fentanyl use. While the study shows benefit, providers should still assess individual patient readiness, comorbidities, and manage precipitated withdrawal risks. Clear discussion with patients about the rapid induction plan is key.

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Trends in Daily Nicotine Vaping and Unsuccessful Quit Attempts in Youths

In a pooled sample of ~115,000 U.S. students (2020–2024), past-30-day nicotine vaping decreased substantially, from ~18% to ~10%. In 2024, about one in ten students (≈13%; ~11,600) reported any past-month vaping. Only a small minority vaped daily in 2024 or roughly 1 in 34 students (~3%). Among the full sample in 2024, about 1 in 50 students both vaped daily and reported unsuccessful quit attempts. Although the proportion of daily users among current vapers increased over time, this occurred within a shrinking group of youth who vape. As a result, the overall population of daily vapers has remained essentially flat or declined slightly. During the same period, youth cigarette smoking continued its historic decline. From 2020 to 2024, smoking prevalence fell by ~40% in Monitoring the Future and ~60% in the National Youth Tobacco Survey. By 2024, only 1–2% of adolescents were current smokers, reflecting the lowest levels of smoking ever recorded in the U.S.

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Alcohol use and risk of dementia in diverse populations: Evidence from cohort, case-control and Mendelian randomisation approaches



This new study challenges the long-held belief that light or moderate alcohol use protects against dementia. Using data from more than 550,000 adults in the United States and United Kingdom, researchers found that higher levels of alcohol consumption were linked to a higher risk of dementia, and they found no clear evidence that light drinking is protective. For example, every threefold increase in weekly alcohol use was associated with about a 15% increase in lifetime dementia risk. Importantly, these findings do not prove that any single drink will cause dementia or that zero use is the only “safe” option. Rather, the results suggest a “less is better” pattern for brain health. The overall message for population health is consistent with current guidance from major health organizations: reducing heavy alcohol use and preventing alcohol use disorder can meaningfully lower dementia risk, and avoiding or minimizing alcohol is the approach most aligned with long-term brain health.

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Treatment and recovery from opioid use disorder: The role of pain severity in individuals with moderate to severe pain

A study examining the use of long-acting buprenorphine in patients with opioid use disorder confirms that chronic pain is a clinically relevant predictor of recovery outcomes. Researchers found that while pain severity did not affect treatment retention, greater pain severity was consistently associated with lower abstinence rates and worse psychosocial outcomes, including greater depression, craving and withdrawal. The findings, which were replicated across three studies with different settings, support routine pain severity monitoring at the start and throughout treatment. This ongoing assessment is essential for providing tailored treatment approaches and optimizing the long-term success and quality of life for OUD patients.

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